AB1013 SCHOOL FOR DOCTORS ON THE PROBLEM OF OSTEOPOROSIS - “START WITH YOURSELF”.
Authors: Y. Polyakova, L. Seewordova
Journal: Annals of the Rheumatic Diseases (2022)

Background Observing in practice the attitude of the medical community to the problem of OP, we decided to conduct a course of training lectures for doctors within the framework of the program “Start with yourself” on the basics of diagnosis and treatment of this disease. After the lecture material, the fracture risk was calculated using the FRAX (Fracture Risk Assessment Tool) in the audience before and after the two-energy X-ray absorptiometry (DXA). If necessary, additional examination and treatment were prescribed. Objectives To evaluate the frequency of decrease in bone mineral density in doctors, to raise awareness about the frequency of decrease in bone mineral density (BMD), to assess the attitude to therapy. Methods The risk of fractures according to FRAX was calculated for doctors of therapeutic specialties, DXA was performed at the Center for Osteoporosis of the A. B. Zborovsky Research Institute of KIER, Volgograd. Bone mineral density (BMD) was determined on the Lunar DPX (GE) apparatus. Results The average age of 59 trainees was 54 ± 10.55 (M±σ) years, 36 women were aged 50 years and older, 23 were under the age of 50, the average body mass index –BMI) was 26.51 ± 4.8 kg/m2. 47 (79.6%) of 59 showed a decrease in bone mineral density (BMD) below the norm (according to the T/Z criterion, according to age) in at least two positions. 15 (25.4%) of them showed a decrease in BMD according to the T criterion by -2.5 SD or lower, which corresponds to the diagnosis of “Osteoporosis”. Of these 15 people, 9 had previously undergone DXA, were diagnosed with OP, and drug therapy was prescribed. Only 3 students are constantly taking medications. Another 6 people were previously treated, but for the last 2-3 years they have not been examined and have not taken anything. OP was detected for the first time in 6 listeners, for 2 listeners the diagnosis of OP was a complete surprise, 4 guessed about a possible decrease in BMD, but did not expect to detect such low indicators (T criterion -2.5 and -2.6 SD for the lowest values). Out of 5 students under 50 years of age with a decrease in BMD by the Z criterion of less than -2.0 SD, 4 had significant risk factors. No obvious risk factors were identified in 1 listener. The average values of TL1-L4 were -1.26 ± 1.06 SD [0.8 to -3.1], ZL1-L4 = -0.68 ± 0.9 [+1 to -2.7], the average values for TNeck were -1.14 ± 1.04 [1.5 to -2.7], Z Neck -0.26 ± 0.88 [1.9 to -1.7]. An additional result of the educational event was a change in the structure of patients referred to DXA. The proportion of patients with osteoporosis and osteopenia among the surveyed increased from 65% to 88% after a month after the schools. Conclusion As a result of the study, a high percentage of detection of a decrease in BMD in female doctors was found. Low compliance to treatment was found in doctors over 50 years of age, a positive attitude to preventive measures in younger doctors. Considering that we have just started the educational program, the first students sought to get examined for personal reasons, which probably overestimates the detectability of reduced BMD. At the same time, it should be noted that doctors with an existing history of low-traumatic fractures did not come for examination, citing high employment. It is necessary to further study the problem of the prevalence of BMD reduction among doctors, increase awareness of the problem of OP and the need for early preventive measures to prevent the development of OP. Conducting theoretical and practical classes in small groups based on the assessment of their own survey data makes it possible to increase the interest of practitioners in studying the problem of OP. The greatest interest on the part of listeners is caused by the DXA procedure itself with the decryption of protocols. When creating motivation for doctors’ personal interest in maintaining personal bone health, the likelihood of a more attentive attitude of doctors to the prevalence of OP among the population increases. Disclosure of Interests None declared